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Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 1 DICOM Health Level 7 HL 7 Digital Imaging and Communication in Medicine.

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Presentation on theme: "Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 1 DICOM Health Level 7 HL 7 Digital Imaging and Communication in Medicine."— Presentation transcript:

1 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 1 DICOM Health Level 7 HL 7 Digital Imaging and Communication in Medicine

2 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 2 Communication in a hospital Administration Laboratory Radiologie surgery documentation

3 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 3 Communication in the past Individual interface between ever two systems High developing costs n * (n-1) interfaces for n systems extensive documentation high maintenance costs high expenditure with exchange of equipment

4 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 4 HL7 HL7 is an international community of healthcare subject matter experts and information scientists collaborating to create standards for the exchange, management and integration of electronic healthcare information. HL7 promotes the use of such standards within and among healthcare organizations to increase the effectiveness and efficiency of healthcare delivery for the benefit of all.

5 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 5 Communication with HL7 In 1987 the USA a working group was established with the goal: Supply of formats and protocols for data exchange in the health service Standardization of the contents More efficient communication Standardized language Reduction of the implementation expenditure International Standard

6 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 6 Messages Aufnahme, Verlegung, Entlassung (admission, discharge, transfer = ADT) Anfragen (queries) Untersuchungsergebnisse (result reports) Buchhaltung / Finanzen (finance) Patientenversorgung (patient care) Terminplanung (scheduling) Rezept (pharmacy prescription)

7 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 7 Events The transmission of the messages is triggered by events Example: A01 stationäre Aufnahme Admit A02 Verlegung Transfer A03 Entlassung Discharge A08 Änderung Update

8 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 8 Example Administration Laboratory Radiologie surgery documentation A01 ACK

9 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 9 Example Administration Laboratory Patient unknown query message response message

10 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 10 Composition of messages Messages consists of segments and begin with a Message Segment Header MSH Segments consists of an ordered sequence of fields Fields can be mandatory or optional

11 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 11 Datatypes of fields STStringXPNPerson Name TXTextXADAdresse FTFormatted TextXTNTelefon Number NMNumericIDCoded Value HL7 table DTDateISCoded Value user defined TSTimestampCNComposite PLPerson Location

12 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 12 Example of Codetabelle AttributwertDescriptionBezeichnung FFemaleweiblich MMalemännlich OOtherandere UUnknownunbekannt

13 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 13 A01 ADMIT A PATIENT MSH Message Header EVN Event Type PID Patient Identification [PD1] Additional Demographics [ { NK1 } ] Next of Kin /Associated Parties PV1 Patient Visit [ PV2 ] Patient Visit - Additional Info. [ { DB1 } ] Disability Information [ { OBX } ] Observation/Result [ { AL1 } ] Allergy Information [ { DG1 } ] Diagnosis Information [ DRG ] Diagnosis Related Group [ { --- PROCEDURE begin PR1 Procedures [{ROL}] Role } ] --- PROCEDURE end [ { GT1 } ] Guaranto [ { --- INSURANCE begin IN1 Insurance [ IN2 ] Insurance Additional Info. [ {IN3} ] Insurance Additional Info. - Cert. } ] --- INSURANCE end

14 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 14 Notation of Cardinality

15 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 15 Segments Used in DUMC ADT Messages AL1Allergy Information DG1Diagnosis Information EVN Event Type MRGMerge Information MSHMessage Header NK1Next of Kin OBXObservation PID Patient Identification PV1 Patient Visit PV2Patient Visit - Additional Information ZAPDUMC Appointment Segment ZIDDUMC Patient Identification Extension ZV1DUMC Patient Visit Extension

16 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 16 Example ADT – message admission of patients A01 - Admit a Patient MSH|^~\&|DMCADT||RADIS1|| ||ADT^A01|DMCADT |P|2.2|||NE EVN|A01| |||MCKEL003 PID|||H89213||BOOP^BETTY^B|| |F|JOHN WRIGHT|W|3380 HIDDEN OAK AVE^^DURHAM^NC^27704||(919) |||U|UNK|241639| PV1||I|MIN^2411^01|3|||051001^MASSEY^E^WAYNE|||MRH||||C|||| A||027|||||||||||||||||||A01||10||| ZV1|S|I|N DG1||||CAUDA EQUINA SYN.||W DG1||||CAUDA EQUINA SYN.||A DUMC HL7 ADT Specifications

17 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 17 HL7 with XML Simpler to read Simpler to validate Bute the messages are much more longer –Example : ADT - A01 message 500 characters ADT - A01 as XML 2127 characters Example

18 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 18 CDA Clinical Document Architecture Document Hierarchy Header Body Header Body Header Body Header Body General dianostic finding X - rax finding ECG finding Endoscopy finding Header Body Header Body Header Body X - raxCTMRT Header Body Header Body gastrooesophago Level 1 Unconstrained CDA Level 2 Section Level templates Level 3 Entry Level templates

19 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 19 DICOM Digital Imaging and Communication in Medicine In the year 1983 the American college of Radiology (ACR) and the National Electrical Manufactures Association (NEMA) created a committee. The goal was to develop a standard for medical pictures. In the year 1985 the first version of this standard was presented. The file format and electrical point to point a connection between two devices were defined. In the year 1993, DICOM 3.0 a further developed standard was presented, which made communication possible between different partners over a network.

20 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 20 Goal of DICOM Standard The goal of the DICOM Standard is to achieve compatibility and improve workflow efficiency between imaging systems and other information systems in healthcare environments worldwide Description of the semantics of instructions and the appropriate files. Description of the range of the implemented standards Support of the communication in the network Open to new applications Use of existing international standards if possible and preparation of own standards

21 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 21 Standards Information Object Definition Abstract definition of objects for the transmission of digital medical images and information according these images –Normalized classes contain only attributes, which belong directly to the object; e.g.: the attributes of an x-ray –Compound classes can contain also attributes, which belong indirectly to the object; e.g. the patient data and diagnoses to the x-ray

22 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 22 Standards Service Class Specification Spezification of services: A class of services joins one or more information objects with services that can be performed with these objects. Examples of services: Storing of data Searching Working lists Printing

23 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 23 Standards Data Dictionary centralized registry which defines the collection of all DICOM Data For each element, the data dictionary specifies: — its unique tag, which consists of a group and element number — its name — its value representation (character string, integer, etc) — its value multiplicity (how many values per attribute)

24 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 24 Standards Data Structure and Semantics specifies how DICOM applications construct and encode the Data Set information –For example specification of image compression addresses the encoding rules necessary to construct a Data Stream defines the semantics of a number of generic functions

25 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 25 Standards Message Exchange specifies both the service and protocol used by an application in a medical imaging environment to exchange Messages

26 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 26 Standards Message Exchange This Standard defines: — the operations and notifications made available to Service Classes — rules to establish and terminate associations provided by the communications support and the impact on outstanding transactions — rules that govern the exchange of Command requests and responses — encoding rules necessary to construct Command Streams and Messages.

27 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 27 Standards Network Communication Support Media Storage and File Format

28 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 28 Standards Media Storage Application Profiles specifies application specific subsets of the DICOM Standard to which an implementation may claim conformance. Is required for the exchange of medical images and related data between different applications

29 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 29 Standards Storage Functions and Media Formats for Data Interchange facilitates the interchange of information between applications in medical environments by specifying: –A structure for describing the relationship between the media storage model and a specific physical media and media format. –Specific physical media characteristics and associated media formats.

30 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 30 Standards Conformance defines principles that implementations claiming conformance to theStandard shall follow –specifies the general requirements which must be met by any implementation claiming conformance. –defines the structure of a Conformance Statement.

31 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 31 Standards

32 Worzyk FH Anhalt Telemedizin WS 08/09 HL7 - DICOM - 32 Examples PACS Picture Archiving and Communication System RIS Radiologie Information System heidenheim.de/klinik/Kliniken_und_zentrale_Einrichtungen/R oentgendiagnostik/index.php Integration mainz.de/FB/Medizin/Radiologie/agit/berichte/dicom2004/01_Bildda tenmanagement.pdf


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